Provider Demographics
NPI:1629445382
Name:HUNT, JASMINE SHANICE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:SHANICE
Last Name:HUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12524 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-3209
Mailing Address - Country:US
Mailing Address - Phone:918-849-5728
Mailing Address - Fax:
Practice Address - Street 1:12524 E 37TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3209
Practice Address - Country:US
Practice Address - Phone:918-849-5728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator